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The island paradise of Seychelles is suffering from a drug epidemic of huge proportions. Known for its coral reefs, mangroves and white sandy beaches, , tourists travel to the Indian Ocean archipelago each year for a holiday of a lifetime. But look beyond the private islands, the boutique resorts and high-end restaurants, and the small nation is battling a heroin epidemic of huge proportions. Per capita, the Seychelles suffers from the highest rate of heroin abuse in the world. Jed Lesperance was 20 years old when he first started taking drugs. He is 34 now. At first it was fun,' he said. I was smoking heroin two to three times a day, even stealing from my grandmother to pay for my habit. Within a few weeks, I had become addicted,' he said. Heroin makes the long journey from Central Asia, especially Afghanistan, before being smuggled to the islands via East Africa. Made up of islands, the Seychelles has many porous borders, which makes them hard to monitor and easy for drugs to come into the country. But rather than attempting a 'war on drugs', which would criminalise the large proportion of heroin users in the Seychelles, the head of the anti-drug agency has introduced a Portuguese-style drug policy - considering drug addiction as a chronic disease to be treated. Individuals have access to medical and psychosocial support under both programmes. Mr Lesperance is one of those people who has benefitted from joining a rehabilitation programme set up by the agency. Each morning, he visits one of the country's roaming methadone clinics - white vans that are manned by drug counsellors and qualified nurses to give the correct dose of methadone to recovering addicts. Dozens of people line up outside the open windows of the white van ready to show their ID. Their name, the date and time are logged into a spreadsheet and on receipt of the information, the correct dose of methadone is distributed to them. Mr Lesperance, who has been clean for three months, now works as a pastry chef in a five-star hotel on Mahe, the largest island in the Seychelles. Michelle Sabury, who helps recruit drug addicts on to rehabilitation programmes, agrees that 'he is a completely different person'. Now he looks a lot healthier and is able to go to work each day. We are proud of what he has achieved,' she told the BBC. After receiving methadone, many of those enrolled in the programme stay to talk with their peers or a counsellor before heading off to work or back home. Some arrive with family members in tow, illustrating how the stigma attached to treatment in the Seychelles is slowly disintegrating. One of the counsellors, Levina Mosses, is a reformed heroin addict who now comes to offer support to others hoping to get clean. My boyfriend was a dealer at the time, so I never had to pay for drugs. My only option was to get clean. Ms Mosses left her boyfriend, also the father of her children, 11 years ago - and has been clean ever since. Following the rollout of the rehabilitation programmes, the price of heroin in the Seychelles has plummeted. However, there is another threat mounting in the Seychelles as the popularity of synthetic drugs is now on the rise. Skip to content. US Election. Why Seychelles has world's worst heroin problem. Getty Images. Morning methadone clinics. Drug addiction is considered a chronic disease in Seychelles. Heroin users have two options:. To join a high-threshold MMP, which includes a period of in-patient treatment where they must commit to detoxification Or the low-threshold programme, which focuses on harm reduction. Jed Lesperance takes methadone and has been clean for three months. More on drugs in Africa:. How addict Jesus survived South Africa's drug epidemic Prescription drugs sold illegally in Uganda How a codeine investigation changed Nigeria. The former British colony's economy depends heavily on the fishing industry and upmarket tourism. Five things about Seychelles:. Popular with tourists after overcoming history of coups and mutinies following independence The Duke and Duchess of Cambridge spent their honeymoon there in The archipelago has a high per capita income, good health care and education Much of the land on its islands is protected as part of nature reserves Home to the endangered Aldabra giant tortoises. Seychelles country profile. Seychelles starts 'Britain-sized' reserve.
In all cases of trafficking or being found in possession of heroin or cocaine it is clear that the said drugs have been imported into the country as the said.
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What do we in Canada want? In the first part of this brief, the author sets out the guiding principles of public drug policy under the three main options identified by the Le Dain Commission in its report on cannabis. This will spark a debate over the primary social values in each of those options and will clearly show that drug policy is not based solely on an examination of the toxicity of drugs. It also takes into consideration the issue of citizenship and the values on which citizenship is based. In the second part, the author will provide concrete examples of that situation by analysing current Quebec policy on alcohol and smoking and policies on illegal drugs. This will demonstrate the importance of basing the objectives of our drug policies on clear choices of social values. To feed someone and not love them is the same as dealing with swine. To love someone but not respect them is like raising domesticated animals. Mencius, Chinese philosopher, B. A public policy is an articulation by the government or its institutions of a set of guiding principles for consistent action in a given area. These principles and guidelines for action may be established through force and violence. In that case, we have a dictatorship. Alternatively, these principles may be established through debate intended to maximize their credibility with the public, allowing use of administrative, economic, social and legal strategies for implementation that are recognized as legitimate and consistent, with criminal law and force as a last resort. In that case, we have a democracy. One of the jobs of criminology is to study criminal law to determine whether it is being used in different areas as the method of last resort. The premise here is that criminal law represents a grave act of institutional violence whose use must be limited to cases of threats to social order that cannot otherwise be managed in the short term. Criminal law is first and foremost a mechanism of social exclusion and stigmatization Pires, Recurrent use of criminal law to maintain a policy is considered to signify a failure of its content, an absence of consensus among those affected by the policy, or a lack of sufficient government support to ensure its implementation. But how can we determine whether criminal law is being used to enforce a policy as a method of last resort? To answer that question, we must examine the social values that we wish to promote as citizens. This is the exercise we shall conduct in this brief on drug policies. The report of the Le Dain Commission Le Dain, was the product of a detailed study of the use of drugs for non-medical purposes in which, for the first time, experts from different disciplines joined forces to advise the government on public drug policy through a royal commission of inquiry. In this regard, the first volume of the report on cannabis is particularly interesting: the commissioners all recognize that cannabis has few harmful effects, but fail to agree on a public policy with regard to this drug. As we shall see, the dissension stems primarily from differing visions of the social values that should underlie relations between the government and its citizens. It is essential, explains Campbell, to stop crime-inducing elements from 'contaminating' young people from good families, whose parents may lose all hope of a productive future for their offspring because of drugs, including cannabis. Campbell explains that the government has not only the responsibility to use its public policies to be a guardian of public order and protector of non-independent persons, but also the responsibility to maintain a common morality within society. The government may therefore have recourse to criminal law in response to behaviour that threatens the 'established morality', regardless of the dangers such behaviour presents for the individual or society. The goal is to prevent the disintegration of our existing society through loss of a 'common morality', an essential element of social cohesion and economic prosperity. Although Campbell recognizes that cannabis has few harmful effects, he says the criminal prohibition against its use should be maintained as an embodiment of the moral prohibition:. It seems to me to be an unassailable proposition that the majority may properly prohibit through the law conduct that is manifestly offensive or disturbing to them whether or not that conduct inflicts an injury on any particular person beyond the actor. This principle is recognized in our laws against public nudity. There is every reason to think that the public use of cannabis is offensive and disturbing to the vast majority of Canadians. There is even more reason to think that public use by young people is particularly offensive. Hence, it appears not inappropriate that such behaviour should be forbidden by law. To whatever extent youthful experience of intoxication predisposes to chronic adult intoxication or acts to limit the full and healthy development of human potential it lessens the capacity of the individual for a full, rich and creative life and lessens his potential contribution to his society. But it seems to me that recently we have been far too little concerned with the consequences of placing too many rights and freedoms on the shoulders of the young. Le Dain, From the perspective of legal moralism, the government intervenes in drug use in the name of its responsibility to preserve 'common values' that are vital for the well-being of society. This makes it legitimate to wage a battle, by force if necessary, against the 'contaminants' attacking our society; the government may apply drug controls and prohibitions, and even target specific minority groups, without raising an outcry from other segments of the population if the latter consider those groups to be outside the 'common morality'. Moreover, legal policies and practices are both coloured by this moralistic vision since users, whether or not they are capable of handling their consumption, may be condemned for their choice of 'vice' over 'virtue'. This approach justifies drug prohibitions on the basis of morality rather than public health. Legal moralism dominates current discourse supporting the maintenance of prohibitions against drugs. It is deeply rooted in the history of the Protestant culture as it developed in North America and, as such, it is not surprising that the United States originated the war on drugs and is the main spokesperson for the argument that perpetuates that war. The assumption that underlies this position is that there exists a common morality, which must be protected by the powers that be. Yet the science of morality has been seeking common denominators on which to base a universal morality for centuries:. In other words, our morality ebbs and flows in accordance with our personal ethics, where our ethics are the ideal and morality is the means by which we approach that ideal. Morality and ethics are rooted, therefore, in a relativism of situations, sentiments and values. Rosenzweig, In fact, there is no common morality other than the refusal to respect the very real pluralism of values held by the individuals and groups in society. The reasoning behind legal moralism is valid: when everyone thinks the same way, social management is simpler, in the way that a dictatorship is a simpler method of political management than the democratic search for consensus. Anyone who has had the experience of repeated meetings knows this. Democracy is a long and sometimes arduous process. But would we, as citizens, prefer to remain uninformed and instead allow the political authorities to decide which social values to promote and impose on us, by force if necessary? If we choose the search for consensus, the process of constructing our drug policy is necessarily going to involve an encounter with the pluralism of values. And to arrive at a policy that respects that pluralism, we must take the time to inform the public properly about the foundations of the policies we advocate. To impose a drug policy in the name of a common morality, is to impose the morality of certain specific groups. This leads us to the first question concerning social values: to what extent does the prohibition of drugs, under the current public policy, represent an imposition of the values of certain groups in society? We will answer some aspects of this question in the second part of this brief. For now, let us continue examining other positions on cannabis policy from the Le Dain report. The majority report of the Le Dain Commission, which is based on the political philosophy of H. It calls for decriminalization of cannabis because of its relative harmlessness, but not legalization, stating that the law should not encourage the use of products harmful to health of our young people. The commissioners explain that they understand the need to preserve individual liberties at any price but take the view that the government, in addition to being the guardian of public order, has a paternalistic function that allows it to use certain forms of legal constraint to prevent non-independent persons from harming themselves. The government therefore has a responsibility to use criminal law to restrict the availability of cannabis, particularly for young people. This position, common in countries where the Catholic culture dominates, opened the door to medical control over drug use in the name of public health protection, assuming that the experts have the necessary knowledge to protect individuals who do not know better. This position is more complex than the previous one. First, there is the entire question of non-independent persons. Who designates these individuals? Second, there is the significance of the term 'protection', a key issue when it comes to drugs. Does it include protecting individuals against their will, and by force, if need be? And protecting them from what? Let us look at the first question. Historically, it has long been maintained that the working class was incapable of handling alcohol, in contrast to the upper class. Today, Aboriginal people are considered inferior to whites in this regard, somewhat in the same way that in the United States, Blacks are less able than whites to handle illicit drugs. This form of discrimination may also be applied to homosexuals, supposedly less able than heterosexuals to handle their sexuality, and women, less capable than men of handling their emotions. These preconceived notions dodge the whole issue of the living conditions of certain populations relative to other, dominant ones, and the values promoted in order to maintain such dominance. Of course, there are more fragile populations in a society with which the government must concern itself. Must this, however, take the form of prohibitions and punishments to ensure their welfare? This leads to the question of 'protection'. It is possible to protect people by making them more independent, better able to make choices, and by improving their living conditions and access to services and information. It is also possible to decide that if these people make choices that do not conform to our values, it is because they are unfit to do so, and we must impose choices on them by force. Every parent can see the difficulty here. There are emergency situations in which, in the short term, a prohibition is most appropriate: 'Do not cross the road without Mommy! So we prepare our children by giving them information and teaching them how to judge when it is safe to cross the road, for their own sake and that of others. However, should an unfortunate accident should occur, we would hope that it is not fatal and that the hospital will provide the best possible care. In legal terms, the argument in favour of prohibition as a way of protecting young people does not make much sense. It is not possible to justify a prohibition that includes adults on the pretext that we wish to protect the health of children, just as we would not prohibit adults from drinking wine on the premise that it is dangerous for children. Protection would be better accomplished by regulating the quality and marketing of a product, and prohibiting its consumption by minors. The basis for this position, which combines punishment and conditional treatment in the name of paternalism and protection of the weak, is the refusal to consider that the role of the government is to maximize the opportunity for each individual to become a full-fledged, independent citizen. Has this been proven with respect to drugs? Van Ree, Rather the opposite. The war on drugs has not only failed to meet the public health objectives of preventing addiction, intoxication and abuse, and prompting an overall decrease in drug use, it has actually aggravated the situation by fostering a black market for drugs and depriving thousands of medical treatment. This situation prevails in Canada as well as elsewhere. Beauchesne, New trends and attitudes to certain illicit drugs over the past thirty years indicate that, despite having been prohibited since the early 20 th century, when reasons for their consumption changed, new groups have begun to try them. Lifetime use of illegal drugs, by province, by persons aged 15 years and over, Canada in percentages. LSD, speed, heroin total use 8 British Columbia These data cannot be explained solely by lack of information on the potential harmfulness of these drugs, the deviant personalities of the users or the new availability of these products. Of course, the drugs must be available. But availability is not sufficient to explain their consumption. By way of illustration, let us also look at some data on alcohol consumption in Canada. Quebec has always had a more liberal policy on drinking age and sales outlets for alcohol than the other Canadian provinces. Smart and Ogborne, The most recent data are as follows:. Prince Edward Island 4. Because there are more liquor outlets in Quebec, people assume that alcohol consumption is greater. In fact, the number of outlets in Quebec did increase from to over 12, with the passage of Bill 21 in , a bill that permitted the sale of beer and wine in small grocery stores and considerably longer hours of business an additional 40 hours. Alcohol consumption before and after passage of the bill was measured: despite the much greater availability of this drug in Quebec under the new law, there was no significant change in its consumption, and the percentage of drinkers in Quebec remained below the national average. Lamarche, This example shows that drug consumption is not motivated solely by availability, while restricting availability does not automatically lead to a drop in consumption. According to studies conducted by the Addiction Research Foundation, health concerns are more likely to be the determining factor in this decision:. Many studies have come to the same conclusion: fear of punishment or its severity have little deterrent effect on users. Similarly, cocaine users consider the threat of the law insignificant. What appears to be much more important, in contrast, and contributed to a reversal of the trend toward illicit drug use in the seventies is the growing perception that certain methods of drug use are harmful, a perception that also contributed to increasing social disapproval of these methods of use. If we weigh concern regarding the legal risks and concern over the health risks for drug users, health concerns clearly come out ahead. As a preventive tool, criminal law is particularly ineffective in deterring young, first-time users. The decline in illicit drug use is independent of criminal law, therefore, and will not be significantly affected by greater criminalization. Erickson, In short, studies to determine how effective the law is at decreasing public health problems related to drug use show that criminal law has little effect; at most, the law may decrease the consumption of specific drugs by limiting their availability. There is no proof, however, that use of one drug is not simply replaced by use of other, sometimes more dangerous, drugs. This is what happens with the black market fostered by the war on drugs. In the absence of a legal market, the black market meets the demand for illicit drugs. Drug trafficking networks have developed that do not allow for regulation of product quality or distribution:. Illegal street-drugs have a set of risks all their own. Users of street-drugs can never know exactly what they are taking. Dealers may not know or reveal exactly what they are selling. Some drugs are laced with other drugs or chemicals which can be harmful. Often one drug is sold in place of another. In nearly two-thirds of all street-drug samples tested by the Addiction Research Foundation of Ontario were found to be different from what they were alleged to be by the seller. That means that about two out of every three times a drug was bought on the street, it was not what the buyer thought it was. Health and Welfare Canada, This harks back to the days of alcohol prohibition, from which we seem to have learned little. Nadeau, In fact, the current drug laws present a much greater danger than Prohibition. Since these laws are international, the black market operates in more than 60 countries, and its size has attracted major players with much greater means; prohibitions have made the illicit drug trade into a flourishing international market. Dealers in this market have the same objectives as in any lawful market: identifying a potential clientele, ensuring its regularity, creating new clienteles, and so forth. However, since the trade, concentration and quality of products are not regulated, any effort to expand the market is permissible, whether it be the sale of drugs to children or the sale of highly toxic products. Some dealers even attempt to create lifetime customers, by encouraging methods of consumption that can more easily create dependence than other, safer ones. Dealers also try to reach a broad market by offering drugs at various prices; depending on the locale, cocaine, amphetamines or crack will dominate. Dealers similarly seek to extend their markets geographically by dumping drugs in previously unexplored areas so as to attract new clients. None of this should be surprising. Right now the drug trade is a highly profitable one that operates worldwide. It is worthwhile for traffickers to use the best possible techniques for distributing and promoting their products. The result is that the black market is much more effective than a lawful, regulated market would be in promoting use of drugs, with hundreds of thousands of dealers actively penetrating all segments of society. There was also violence associated with this market, not because of the nicotine, but because of the operating rules of the black market. Not only have prohibitive drug laws failed to diminish the consumption of illicit drugs therefore, they have also prompted the development of a black market in which lack of control over drug quality, concentration and places of distribution promote intoxication and make it extremely difficult for users to learn how to handle drugs. Moreover, they deprive thousands of sick people of drugs that could ease their suffering, as demonstrated by many studies on therapeutic use of illicit drugs. Finally, the war on drugs deprives illicit drug users of appropriate medical treatment for problem habits. Such users, especially young people , are often reluctant to seek medical assistance for fear of encountering repression, lack of understanding, and discrimination. In short, who does prohibition protect if it leads to a higher incidence of public health problems? At present, there can be no doubt that the cure is not only ineffective against the disease, but that, to use a familiar metaphor, its effects are worse than the disease itself. Simply stated, drugs are more dangerous because they are illegal. Just as tens of thousands of people died or were blinded or poisoned by bad bootleg liquor 60 years ago, perhaps the majority of overdose deaths today are the result of drug prohibition. Ordinarily, heroin does not kill. It addicts people and makes them constipated. Fewer people might take those drugs, but more would get sick and die. That is exactly what is happening today with the illicit drug market. Nadelmann, The violence will be even worse if the adversaries have been encouraged to assume a 'warrior mentality' through lack of public information and the consequent fear. Those deemed 'non-independent', on whose behalf this prohibition has been justified are likely to pay dearly:. War mentality cleaves the world into noble allies and despicable enemies; justifies any measures necessary to prevail, including violence to innocent bystanders; and disdains accommodation, compromise, or any questioning of authority until total victory is achieved. In essence, war mentality suspends normal human compassion and intelligence. This mentality pervades current Canadian drug-control efforts. Alexander, What social values underlie the legal paternalism inherent in maintaining a prohibition that has created a context of violence, more serious public health problems and a black market that actively recruits young people? This report takes the position that the government, as a guardian of public order, must restrict its actions to those areas that disturb the public peace in general, such as road safety, and limit its actions so as to preserve civil rights to the greatest extent possible. Penal repression and mandatory treatment of cannabis users represent an abuse of the power of the government and its institutions since this relatively harmless drug could be handled properly by consumers if the government regulated its marketing and quality. From this standpoint, the fact that many people find certain methods of drug use morally suspect does not make it legitimate for the government to regulate them by prohibition, unless such use constitutes in itself a threat to others. Does this mean that in a context of legal liberalism, the government has no responsibilities with respect to drugs unless such a threat exists? Quite the opposite. Prohibition is not the only form of intervention. For a better understanding of the role of the government in a context of legal liberalism, some terms must be clarified. First, we must distinguish legal liberalism from economic liberalism. Economic liberalism implies a withdrawal by the government to let market forces play; this ultimately results in rampant capitalism in which the strongest get stronger while the weakest are left to themselves, with no means of changing their condition or achieving a satisfactory quality of life. In other words, when it comes to drugs, the government is responsible for ensuring the safest possible context for drug use and for establishing the conditions needed to minimize any harmful effects of such use. Does this mean that the government promotes drug use or abandons its capacity to intervene in order to prevent abuse? On the contrary. This is confusing legal liberalism with libertarianism, which does not grant the government any social or political responsibility nor any legitimate authority to limit individual freedoms in any way whatsoever. This philosophy, which has its supporters in relation to drug use, is quite distinct from legal liberalism. In the area of drugs, defining precisely what is meant by legal liberalism and the social values that underlie this philosophy requires explanation and discussion of the harm reduction approach. The harm reduction approach to drugs has two components: reducing high-risk use and reducing the negative consequences associated with problem use. Reducing high-risk use may involve efforts to decrease demand for the product itself if any use of that product is high-risk as in the case of tobacco , or may involve discouraging high-risk use or methods of use that are risky such as drinking and driving. With respect to reducing the negative consequences of problem use, intervention may involve decreasing the problems associated with such use for example, teaching abstinence or controlled drinking or decreasing the environmental conditions that increase problem use for example, through public policies that ensure a safe market. This approach is characterized by two principles: pragmatism and humanism. While the 'cultural' roots of the harm reduction approach are connected with drug use itself, through the transmission of the knowledge and know-how that will enable users to benefit from drugs while minimizing the harmful effects, the political roots of this approach, which led the government to give it some support, are essentially health-related, associated with the advent of AIDS in the s. Since the middle of that decade, however, the concept of harm reduction has broadened in scope and led to profound changes in intervention philosophies, as one major rehabilitation centre, the Centre Dollard Cormier in Montreal, attests:. In other words, the drug problem in itself does not have consequences, it is the consequences that signify a drug problem. Boilard, 5. This change of philosophy has also led a growing number of workers in the field to reject the paradoxical discourse of the law and call for drug users to receive the same treatment as any other citizen. Our patients had freely chosen their lives of poverty, delinquency and physical degradation. AIDS was only one particularly horrible consequence of that choice. We could, using this reasoning, evade our responsibility for perpetuating the epidemic. Mino and Arever, The claim that drug users should be treated the same as any other citizen means that the function of doctors is to keep them alive and in the best possible health. According to a pioneer of this approach in Great Britain, Dr. A doctor offers care and advice and accepts that it is up to the individual to modify his or her lifestyle. For many professionals, this role implies, in the case of drug addiction, first, that addicts have their own opinions regarding their needs and second, that they can be prescribed any drug that can help them and keep them alive, including heroin. This is now an accepted practice in certain clinics in Switzerland, England and the Netherlands. We are also beginning to consider this approach in Canada. This new philosophy, both among health practitioners and the community, has led to a call for the harm reduction approach to expand from a situational strategy linked with the advent of AIDS to strategies legitimized by public health policy. What does this mean in terms of social values? To answer this question, we must first identify the difference between an emergency strategy and a public policy. The harm reduction approach has united players with very different motivations. Some are still essentially fighting against AIDS, and if a vaccine were available, their involvement would probably be limited to an HIV vaccination program. Others have seen the problem of AIDS as an opportunity to help a neglected and often misunderstood clientele that has been difficult to reach. Although AIDS has brought together people with varying motivations and many different approaches to drug users, it is still the case that traditional morality dominates public policy, and harm reduction strategies essentially represent an emergency response to AIDs rather than a change in social values. Actually, these emergency strategies have brought about a change from an uncompromising legal moralism to greater willingness to provide medical treatment for some clients, in a context of legal paternalism. The status of some addicts has therefore changed from that of 'offender' to that of a potentially contagious patient, from whom all 'upstanding' citizens must be protected. Mary, The status of medical patient also perpetuates the public perception that AIDS programs for IDUs will be needed only until these individuals make the 'right' choice to solve their problems, namely abstinence. By viewing the user as sick, this issue can be ignored, along with all the other desires and needs felt by the addict, like any other individual:. Unfortunately, in the hostile environment we live in, our drug use is considered the most important thing about us by those who have power over our lives. Balian and White, In short, although the harm reduction approach can legitimately translate into multiple forms of intervention in response to emergencies in the field, while keeping silent about the law and its effects, it cannot be called a public drug policy nor seek to become one unless the choice of social values that allows us to consider drug users full-fledged citizens creates obligations for the government. In fact, this approach cannot become a true public drug policy unless it is associated with a philosophy of legal liberalism based on humanism, social responsibility and respect for all citizens, including drug users. These values create obligations for the government. What are these obligations? First, just as the government is responsible for ensuring that consumption of food and other products is as safe as possible for the public, it is also responsible for ensuring a safe context for drug consumption. To do so, certain tools designed to reduce high-risk use are essential:. These regulations, if necessary, may lead to modification of some of the components and growing or manufacturing conditions of a drug to reduce its toxicity;. Further, efforts to reduce the negative consequences associated with problem use must also be made, by means of the following:. These elements, essential to the realization of a public harm reduction policy, represent government obligations in a context of legal liberalism which seeks increased autonomy for each citizen in relation to the choices offered. Bearing in mind this social responsibility on the part of the government, and the need for humanism and respect for the drug user as a citizen, we are now going to analyse some of our current public policies. Recent studies on alcohol clearly demonstrate that a public policy aimed at decreasing consumption, regardless of its method of management, can result in failure to reach the ultimate objective of reducing problems. In other words, an average decline in alcohol consumption does not necessarily translate into a decrease in drinking problems, as is shown by studies done in Australia, England, Ontario and Quebec. In an interview in this regard, Louise Nadeau gave a clear explanation of this phenomenon Denis, :. A typical example of the first category, Mr. X always drinks two glasses of wine at dinner. Numerous studies indicate that moderate drinkers are healthier than abstainers, even after excluding the influence of such variables as age and physical activity. In short, for Mr. It is a different story for Mr. Y, who drinks the same amount of alcohol in a week, but all on one or two occasions. The physician disapproves, and the social worker is starting to take an interest. A significant portion of those who drink too much alcohol drink because they have problems. The number of moderate drinkers has shrunk while the number of abstainers has grown. Returning to our example, Mr. X has replaced wine with mineral water. If drinking was not politically incorrect, his or her doctor might be somewhat critical of this. The drop in consumption has a perverse effect, therefore. But it gets worse. The same data show that the heavy drinkers, the ones who get drunk, are not drinking any less In Quebec, the drinkers who still overdo it form a hard core. To reach them, according to Louise Nadeau, we must change the message. But first we must change our objective:. We would try to decrease the incidence of excessive drinking \[harm reduction\]. Denis, In fact, from the standpoint of legal liberalism, it is an abuse of power for the government to seek to regulate alcohol-related behaviour on a moral basis or to decrease alcohol consumption regardless of its management. However, the government has a duty to provide a safe environment and the official mechanisms needed to implement programs to reduce both heavy use of this drug and the harmful consequences that result. As for any drug, light and heavy use present different levels of risk. This distinction between light and heavy use has been very slow to make an impact in the political sphere: the issue of alcohol use is still strongly associated with the idea of abstinence as a moral ideal for all citizens. These are the social values revealed in the virulent debate on controlled drinking programs see Tucker, Donavan and Marlatt, , and in the recent debate on criminalization of drinking and driving which sees recourse to criminal law gaining in popularity. This last statement merits further discussion. Educational campaigns intended to change the behaviour of people who drive motor vehicles while their faculties are impaired focus primarily on alcohol consumption. Similarly, criminal infractions for impaired driving apply almost exclusively to drunk driving. The Criminal Code contains a specific charge for those who drive with more than 80 mg of alcohol per ml of blood. Defining the penalty in terms of alcohol level means that no preventive effort is focused on other factors:. In the case of young people, we must remember that they are usually very inexperienced drivers. They may not be skilful enough because they have not had enough opportunities to drive. In addition, they may not be as aware of how alcohol affects them and their ability to drive as an older driver with more experience. Cormier, Brochu and Bergevin, The focus on drinking and driving allows the government to avoid costly measures relating to road safety economical and convenient public transit, road repairs, improved signalling and safety standards for automobile manufacture, and so on and fails to teach drivers the importance of not driving while impaired, regardless of the cause: fatigue, cold medications that reduce attentiveness, strong emotions following an argument, and so forth. Instead of teaching members of the public to assess whether they can drive well enough to ensure the safety of themselves and others, they are taught to be afraid of the police, since 'drinking and driving is criminal!! Emphasis on the danger of getting caught drinking and driving rather than a more comprehensive attempt to prevent driving while impaired creates perverse effects. For example, a person has had a few drinks; for fear of police roadblocks, he or she takes an alternative route or waits a few hours, without drinking, before leaving. Finally, the person drives, without necessarily being sober, but practically falling asleep at the wheel. Where is the prevention of impaired driving in this situation? This person has not made a choice based on his or her ability to drive, but solely based on the possibility of getting caught. Statistics may indicate a decline in drunk driving, but would road safety have increased as much if social values regarding the responsibility to drive unimpaired had not changed? Not necessarily. If the true objective of the law is to prevent driving while impaired in order to decrease the presence on the roads of drivers who represent a potential danger to themselves or others, someone who is very tired, has taken cold medication, has just quarrelled with his wife, has worked overtime, is too elderly and so on, may have impaired faculties and constitute a potential danger to himself and others. Why isolate one of the causes and give the government the right to forceful use of criminal law in that case only? Is there driving with 'good' impaired faculties and driving with 'bad' impaired faculties? In terms of road safety, the issue is to determine whether a person is in a state to drive, regardless of the reasons, not to determine whether he or she has consumed alcohol. From this standpoint, would we be as quick to resort to criminal law as a way of 'correcting' all impaired drivers? Probably not. What makes the use of criminal law so easy as a solution to the problem is the perception that it is 'immoral' to drink and drive, an argument that is difficult to uphold if the definition of impaired faculties no longer focuses solely on alcohol consumption before driving but on better road safety in general. It is particularly important to rethink how to reduce the problems caused by impaired driving now that new tests, such as urine and blood tests, have been developed to detect drivers who have consumed other drugs. These tests could represent a major abuse of power, especially since the drug-testing industry is seeking to expand its market. Hanson, In fact, legal moralism is still a major part of public policies on alcohol. This statute sets out the rules applicable to tobacco use, sale and advertising and promotion. Among other things, it prohibits smoking in many public places health and social services institutions, schools, day care and preschool centres , and establishes standards for the construction, ventilation and design of smoking areas in many other places. The target of this legislation is smoking rather than smokers; that is why it clearly avoids any general prohibition of tobacco consumption, rejecting the 'zero tolerance' spirit of some anti-tobacco groups. That the government avoided moralism in this policy is good. That it established that reducing high-risk use amounts to reducing the overall demand for tobacco, given the harmfulness of this drug, is also consistent. However, in the context of a policy based on the values of legal liberalism, the government is also responsible for reducing the harmfulness of this drug, considering the fact that many people still use it. But, faced with a powerful tobacco lobby, the capacity of the government to regulate product quality by altering the growing or manufacture of this drug to reduce its toxicity and addictiveness, is quite limited. That battle is not yet over, however. Second, in a policy consistent with legal liberalism, preventing tobacco use should involve much more than prohibitions and coercion, or it opens the door to a moralism that discriminates against smokers. And such moralism does indeed exist. Harm reduction for heroin addicts, on one hand, and a witch hunt for smokers, on the other. Second, the problem of considering global reduction in demand and the ideal of abstinence without associating these objectives with intolerance of the users of this drug. The debate over the possibility of refusing to perform cardiac surgery on smokers is a sign of this intolerance. Would we refuse to treat people who do not get enough exercise, eat a proper diet, reduce their level of stress, and so forth? These are all high-risk behaviours that could potentially be changed. Why should tobacco use be treated any differently? Because it has become an immoral drug. In its recommendations to the department, the committee explains that the objectives of the Quebec policy on illegal drugs are still based on the moralistic goal of reducing drug use, regardless of the risks involved. It clearly calls for the government to abandon the federal strategy of zero tolerance supported by the law, and for recognition of the fact that repression is the main source of harm for users of these drugs. The CPLT suggests changing the objective, '\[Translation\] increase the number of people who never use illegal drugs', to the following: 'reduce the number of people who make excessive or inappropriate use of illegal drugs and reduce the harm associated with use of these drugs, for the users, their family and friends and all of Quebec society'. Wartime medicine is actually needed in the current context; but to give it the status of public policy is to legitimize the harmful effects of this war as 'normal', without questioning the basis of the war itself. It is like establishing a public environmental policy involving distribution of gas masks to people living in the vicinity of industries that are major polluters. It would send a message that such industrial pollution is a normal situation to which the public must adapt and that the government is graciously supplying gas masks to those segments of the population who cannot afford to live elsewhere. In his report, Chief Coroner J. Cain of British Columbia Cain, emphasizes that repression is extremely expensive, both in terms of implementation and outcome. He is referring, of course, to the staggering costs of police intervention and the involvement of the criminal justice system, particularly in the case of simple possession cost of arrests, court appearances and in some cases, prison sentences. In addition, there are those who are introduced to injection drugs and high-risk use in prison, who go into debt for drugs and must pay the cost upon release, physically, socially and financially. To these direct costs of repression he adds the indirect costs that fall on the health system and social services agencies in general. There are, for example, the injection drug users who, fearing this repression, delay treatment, with the tragic result that much more serious intervention is needed; there is also the rise in cases of HIV, hepatitis, and the much more serious deterioration in living conditions caused by the black market. Finally, the increase in the harmful effects of repression for addicts is not limited to the individual, but extends to his or her family particularly children and society in general criminality, deterioration of the neighbourhood, growing numbers of dealers on the street trying to support their habits, and so on. Moreover, addicts who are HIV-positive or have Hepatitis A or B have sexual contact with non-addicts, thus increasing the incidence of these diseases in the rest of the population. Many are occasional users and can be found at work, at school, in clubs and bars, and so forth. Cain refers to all these costs and openly raises the question of our repressive approach to drugs, as well as the laws that embody this approach. Even if there is increasingly open recognition in some public documents that repression, or enforcement of the law, is the main source of harm for drug users, it is less clearly stated that prohibition and the laws themselves are the main source of the black market and repression. The problem should be considered not only in light of the deaths associated with heroin and cocaine, but with reference to all illicit drugs available, the so-called 'hard' and 'soft' drugs alike. Legalization should not be considered the panacea or solution to substance abuse problems plaguing British Columbia and the rest of the country. It would not solve all the anti-social and criminal acts committed by confirmed addicts. Nor do I believe legalization would increase the incidence of those acts. On the contrary, what it would do is create that necessary 'window of opportunity' for the addicts who have lost hope and freedom of choice. The advocates of this statute justified this expansion of power by the need for more effective weapons against clandestine laboratories manufacturing synthetic drugs. Canadian Foundation for Drug Policy website. There are still 65, drug-related criminal charges in Canada each year, and Canada is second, after the United States, in terms of incarceration of drug users. This must not be forgotten. Moreover, it has been noted that the more cannabis is considered a harmless drug with no addictive power, no longer a priority for repression, the statistics in this regard say something else, both in Canada and elsewhere. In Canada, 45, of these criminal charges are related to cannabis, and 30, represent cases of simple possession. While it is true that police priorities have changed, so that private consumption is disregarded at the investigation level, and that the judicial system gives few prison sentences for simple possession, cannabis charges have actually increased since while cocaine and heroine charges have dropped. Furthermore, these thousands of people still have criminal records. To date, more than , Canadians have criminal records because of cannabis. Boyd, Groups lobbying in support of this new statute also justified its increased powers of repression by stating that we had to conform to the International Conventions and had little flexibility as a result. This is false. The Conventions oblige us to have certain prohibitions, but leave significant flexibility in how to apply them. The recent decisions in favour of repression convey to the public not only that intervention to counter the harmful effects of this war is normal, but also that drug users have the primary responsibility in this regard, encouraging hostility toward them; it also perpetuates the host of contradictions surrounding the development of harm reduction strategies because of the official priority given to health budgets for HIV prevention. In fact, without any explicit challenge to prohibition, we are left with the legal moralism and legal paternalism that so thoroughly permeate the issue of legal and illegal drugs, preventing the government from assuming its responsibilities in this area: to normalize use, recognize the benefits as well as the harmful effects, treat users as full-fledged citizens and conduct prevention and intervention activities in a safe context where criminal law is used as the method of last resort. Roelandt, We must no longer consider it normal for public health activities to correct the actions of our justice system. We must refuse to restrict the harm reduction approach to a wartime medicine. Drug policies are currently being developed amid tremendous anarchy, as there has been no debate over the objectives of drug policy and the underlying social values. As a result, initiatives are being taken today to stop people from using drugs, yet at the same time safe places are being set up for people to use intravenous drugs, and some drug users are being locked up, yet at the same time, sterile needles are being handed out in prisons. This state of affairs means that counselors who want to help integrate drug users into society have to work surrounded by the damaging effects of prohibition and ensuing efforts to stop people from using drugs and to constantly justify themselves to a public that is hostile toward their clients. Workers in the field are growing more and more uncomfortable, because it is difficult in the circumstances to clarify priorities and the ethical boundaries of their intervention, overcome operational problems and set adequate criteria for evaluating program results. This explains why many people are beginning to find that the argument that drug use prevention fights AIDS exacts a heavy toll in dealing with drug addicts, and drug addicts, as stated earlier, are starting to claim to be something other than a possible source of contamination or are challenging the political status of the requirement that they be labelled 'sick' in order to receive assistance and support. This will not bring about change overnight, but it will provide some direction and help in choosing more consistent and more credible actions. To quickly recap those values:. Legal moralism. This line of thinking leads to drug users being blamed for their own economic, health and criminal problems. Legal paternalism. Drug users who do not know what they are doing and find themselves awash in legal, economic and health problems thus come to bear sole responsibility for their plight. Legal liberalism. The government has to account for the opportunities it gives people to use drugs safely by compiling and providing access to information on soft and hard drug use, setting up adequate high-risk drug use prevention programs and by offering the most appropriate services and care for people who have developed drug problems. The same principles underlie the harm reduction approach. But if civil rights are to be given maximum respect, this also means that criminal proceedings should be the method of last resort for handling problems encountered in the course of harm reduction. Opting for legal liberalism in dealing with drugs, as in any other area, is a necessary ideal in a democratic society. Everyone, from the lowest of the low to the highest of the high, has a duty to use whatever forum he or she is afforded to state how drugs should be addressed. But only if we pay that price will be able to say that we have implemented a Canadian drug policy which is based on humanism, social responsibility and respect for drug users as full citizens. In short, that is the price of democracy and the way to reduce the public health problems caused by drugs. Le dragon domestique. Paris: Albin Michel. Paru en , sous un nouveau titre: La drogue dans le monde, hier et aujourd'hui. WHITE Defining the drug user. International Journal of Drug Policy. Mixed response to prison methadone program. The Journal of Addiction and Mental Health. Erickson, D. Rieley, Y. Cheung et P. Drogues et droits de l'homme. CAIN, J. Paris: CNRS. The Enforcement of Morals. DION, G. O,HARE Toronto: University of Toronto Press. Nelken ed. The futures of criminology Sage Publications: London, Le Journal Vol. HART, H. Stanford, Calif. RILEY Responding to aids and drug use in Prisons in Canada. The International Journal of Drug Policy. International Journal of Drug Policy Vol. Rapport- Le cannabis. Ottawa: Information Canada. MARY, P. Document de consultation. Parlement des Pays Bas. MINO, A. Provision of syringes and prescriptions of heroin in prison International Journal of Drug Policy. Les Cahiers de Prospective Jeunesse Vol. Bruxelles: Prospective Jeunesse. I Psychotropes vol. Menu - ille. Past Session:. Select a different session. Of course, in many matters of public policy, the lines are not so clearly drawn. Although Campbell recognizes that cannabis has few harmful effects, he says the criminal prohibition against its use should be maintained as an embodiment of the moral prohibition: It seems to me to be an unassailable proposition that the majority may properly prohibit through the law conduct that is manifestly offensive or disturbing to them whether or not that conduct inflicts an injury on any particular person beyond the actor. Le Dain, From the perspective of legal moralism, the government intervenes in drug use in the name of its responsibility to preserve 'common values' that are vital for the well-being of society. Rosenzweig, In fact, there is no common morality other than the refusal to respect the very real pluralism of values held by the individuals and groups in society. Beauchesne, New trends and attitudes to certain illicit drugs over the past thirty years indicate that, despite having been prohibited since the early 20 th century, when reasons for their consumption changed, new groups have begun to try them. Drug trafficking networks have developed that do not allow for regulation of product quality or distribution: Illegal street-drugs have a set of risks all their own. Nadeau, In fact, the current drug laws present a much greater danger than Prohibition. Those deemed 'non-independent', on whose behalf this prohibition has been justified are likely to pay dearly: War mentality cleaves the world into noble allies and despicable enemies; justifies any measures necessary to prevail, including violence to innocent bystanders; and disdains accommodation, compromise, or any questioning of authority until total victory is achieved. Since the middle of that decade, however, the concept of harm reduction has broadened in scope and led to profound changes in intervention philosophies, as one major rehabilitation centre, the Centre Dollard Cormier in Montreal, attests: \[Translation\]. Mino and Arever, 34 The claim that drug users should be treated the same as any other citizen means that the function of doctors is to keep them alive and in the best possible health. Mary, The status of medical patient also perpetuates the public perception that AIDS programs for IDUs will be needed only until these individuals make the 'right' choice to solve their problems, namely abstinence. In an interview in this regard, Louise Nadeau gave a clear explanation of this phenomenon Denis, : \[Translation\] In other words, there are two categories of drinkers that should not be confused. But first we must change our objective: \[Translation\] Given what we now know, if we wanted to make sensible recommendations to the department, we would no longer set the objective in terms of overall volume \[demand reduction\], says the researcher. Defining the penalty in terms of alcohol level means that no preventive effort is focused on other factors: \[Translation\] Alcohol consumption is not the only possible factor in an automobile accident; there are many others, including road and weather conditions, speed limits, mechanical failure, sudden health problems, and so on. Cormier, Brochu and Bergevin, The focus on drinking and driving allows the government to avoid costly measures relating to road safety economical and convenient public transit, road repairs, improved signalling and safety standards for automobile manufacture, and so on and fails to teach drivers the importance of not driving while impaired, regardless of the cause: fatigue, cold medications that reduce attentiveness, strong emotions following an argument, and so forth. Beauchesne, Second, in a policy consistent with legal liberalism, preventing tobacco use should involve much more than prohibitions and coercion, or it opens the door to a moralism that discriminates against smokers. Beauchesne, The advocates of this statute justified this expansion of power by the need for more effective weapons against clandestine laboratories manufacturing synthetic drugs. Canadian Foundation for Drug Policy website There are still 65, drug-related criminal charges in Canada each year, and Canada is second, after the United States, in terms of incarceration of drug users. Boyd, Groups lobbying in support of this new statute also justified its increased powers of repression by stating that we had to conform to the International Conventions and had little flexibility as a result. Beauchesne, The recent decisions in favour of repression convey to the public not only that intervention to counter the harmful effects of this war is normal, but also that drug users have the primary responsibility in this regard, encouraging hostility toward them; it also perpetuates the host of contradictions surrounding the development of harm reduction strategies because of the official priority given to health budgets for HIV prevention. Roelandt, We must no longer consider it normal for public health activities to correct the actions of our justice system. To quickly recap those values: Legal moralism. BOYD, N. Rethinking our policy on cannabis Options politiques. Interface Vol. XVII 1 Paris: Gallimard, LAP, M. MILL, J. On Liberty. New York: Norton. Sites internet Actup: www. Setting public policy on drugs: a question of social values What do we in Canada want?
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